Organization
CARDIOVASCULAR DISEASES OF NILES, P.C.
Active
Organization
CARDIOVASCULAR DISEASES OF NILES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUNDATHAJE ISHWARA BHAT M.D. (PRESIDENT)
(269) 683-1120
Entity
Organization
Contact information
Practice address
24 N SAINT JOSEPH AVE, SUITE A, NILES, MI 49120-2263
(269) 683-1120
(269) 683-4325
Mailing address
24 N SAINT JOSEPH AVE, SUITE A, NILES, MI 49120-2263
(269) 683-1120
(269) 683-4325
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
42240
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0601110821
BCBS MI
MI
05
—
101365131
—
MI
Enumeration date
03/21/2008
Last updated
05/06/2008
Update your record
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